chapter 23 pharmacology

The nurse on a psychiatric unit contributes to the care of many clients, most of whom have physical as well as psychiatric health problems. For which client would clozapine most likely be contraindicated?

45-year-old with bone marrow suppression

A nurse is explaining to another nurse the difference between first-generation antipsychotics and second-generation antipsychotics. What is the biggest benefit of the second-generation antipsychotics?

Decreased extrapyramidal effects

A parenteral form of an antipsychotic is prescribed for a client who has become aggressive. When administering the drug, which site would be most appropriate for the nurse to use?

Gluteus

After administration of haloperidol to an acutely dehydrated client, the nurse should prioritize what nursing assessment?

blood pressure

What medication is an example of a phenothiazine antipsychotic?

chlorpromazine

The nurse should recognize what as the primary goal of treatment for haloperidol therapy?

decreased agitation and combativeness

The nurse is caring for a client who has been taking an oral neuroleptic medication for several years. What assessment should the nurse prioritize to best address the risk for adverse effects?

monitoring the client for involuntary facial movements

Chlorpromazine is contraindicated for a client with what medical diagnosis? Select all that apply.

stroke cirrhosis major depression

A client's medication has been changed to clozapine. What assessment should the nurse perform to identify a life-threatening adverse effect early?

vital signs monitoring

During health education with the nurse, what subject should be the primary focus for a client newly diagnosed with schizophrenia?

the importance of adherence to prescribed treatment

For clients taking clozapine, it is necessary to regularly monitor what lab test during the initial months of therapy and periodically thereafter?

white blood cell (WBC) count

A client is being treated with clozapine. What should the nurse monitor most closely?

White blood cell count

For clients taking clozapine, it is necessary to monitor what lab test for the first 6 months?

White blood cells

A client has just been prescribed a phenothiazine. During client teaching about this drug, what would be important for the nurse to tell the client?

"Don't be surprised if your urine turns pink or reddish. This doesn't mean you're bleeding."

A female client 25 years of age has begun taking lithium for treatment of bipolar disorder. Which statement indicates that the client needs further instruction?

"I will need to stop taking my birth control pills while I take lithium."

A family member asks if a relative, who is taking prochlorperazine for schizophrenia, can go on a beach vacation. What is one point of education that the nurse would make sure the client and family understand?

"Prochlorperazine can make you very sensitive to light. Make sure you wear sunscreen and cover up as much as possible to prevent sunburn."

A client has been admitted to the hospital following an acute schizophrenic episode. Which would be a priority question for the nurse to ask the client's family during the initial interview?

"What was the client doing or experiencing when the episode occurred?"

A nurse is presenting an in-service program about antipsychotic therapy. When describing the possible adverse reactions that can occur, which would the nurse include as an adverse reaction of antipsychotics that is potentially fatal?

Neuroleptic malignant syndrome

A nurse observing a client notices the client has developed muscle rigidity, altered mental status, tachycardia, and sweating. The nurse interprets these findings as suggesting which of the following?

Neuroleptic malignant syndrome (NMS)

A client is prescribed clozapine. When developing the teaching plan for this client, the nurse would integrate knowledge of which of the following?

Only a 1-week supply is dispensed at a time.

A nurse is charting on a client who has repetitive tongue and jaw movements, and a facial tick. What term could the nurse use to document these findings?

Tardive dyskinesia

The nurse on the unit has several clients taking clozapine. For which client is clozapine, an antipsychotic, contraindicated?

The 45-year-old with bone marrow depression

A client who is experiencing withdrawal from alcohol has developed psychosis and is being treated with haloperidol. Which assessment findings should prompt the care team to assess the client for neuroleptic malignant syndrome?

The client develops muscle rigidity and a sudden, high fever.

A 24-year-old client is being seen in the emergency department because of a high fever and cannot move the right arm. During the history-taking process, The nurse discovers the client is being treated with an antipsychotic medication for schizophrenia. The nurse knows that what may be happening with this client?

The client may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately.

A client is prescribed clozapine (Clozaril). The client and family should be instructed on the adverse effects of this medication. What laboratory test is most important in the first 6 months of the medication regime?

Weekly WBC counts

What client is being treated with a typical antipsychotic?

An agitated client who was given haloperidol during acute psychosis

When monitoring a client for possible neuroleptic malignant syndrome, the nurse will plan to implement what intervention into client care? Select all that apply.

Assess temperature every 8 hours. Monitor for signs of respiratory distress. Document urinary output into client records every 8 hours.

A client is started on aripiprazole and the nurse notices the client is experiencing dry mouth and nasal congestion. What intervention does the nurse teach the client to minimize the side effects of the medication?

Drinking frequent sips of water

A 28-year-old woman has been diagnosed with schizophrenia. The health care provider has prescribed a typical antipsychotic, haloperidol. Which will the nurse include in the teaching related to the most common adverse effects?

Extrapyramidal symptoms

Chlorpromazine IM has been ordered for a client on the unit. The nurse caring for a client instructs the client to:

remain recumbent for at least 30 minutes after the injection.

A client, who has been diagnosed with schizophrenia and is taking an antipsychotic medication, reports constant thirst, frequent urination, and feeling nauseous. The nurse knows that the client may:

have undiagnosed diabetes.

A psychiatric nurse is discussing the advantages of atypical antipsychotics with the parents of a teenager who has been diagnosed with schizophrenia. When comparing these drugs with the older, typical antipsychotics, what advantage should the nurse cite?

reduced adverse effects

Monitoring what laboratory test is most important in the first months of clozapine therapy?

regular complete blood counts